Yolanda's Law to address child mental health issues

Michael Morton

Monday

Jul 28, 2008 at 12:01 AMJul 28, 2008 at 8:53 AM

The bill is a response to a 2006 report from Children's Hospital Boston and the Massachusetts Society for the Prevention of Cruelty to Children estimating that 102,000 of the 146,000 children needing mental health services in the state don't receive them.

As she drove past a frozen Framingham reservoir at the beginning of a period she calls the "lost years," Maureen McNamara received a shocking message in sign language from her autistic young son.

"I remember being in bumper-to-bumper traffic and almost causing a 15-car backup," the Westborough mother recalled this past week, more than a dozen years after the incident. "I just remember being so afraid."

It was not until age 10 that Evan was diagnosed with bipolar and obsessive-compulsive disorders. After years of treatment, the now-17-year-old looks forward to taking the bus for his first full year at Westborough High School and considers it a point of pride that his disorders have not sent him to the emergency room in a couple of years.

But McNamara says her son has come this far only after a friend got them a coveted appointment with a booked psychiatrist, who, in turn, secured a spot on the waiting list for an intensive residential treatment program.

Evan was eventually accepted, capping off years spent navigating a complex and fragmented system of care that made treatment for his physical disabilities seem easy by comparison, McNamara said.

"It's kind of the most dysfunctional world you can imagine, the world of pediatric mental health care," she said. "A huge number of children don't fare as well as Evan."

One of those children was Yolanda Torres, a 16-year-old with bipolar disorder who committed suicide in January. The state House of Representatives is expected to vote this week on a bill that will honor the girl and provide more support for mentally ill children, legislation closely followed by the McNamaras and other families.

The bill is a response to a 2006 report from Children's Hospital Boston and the Massachusetts Society for the Prevention of Cruelty to Children estimating that 102,000 of the 146,000 children needing mental health services in the state don't receive them.

Already passed by the Senate, the legislation would increase mental health screenings by pediatricians, as well as at day care and preschool, and would provide more assistance to schools. It would also provide more options for consumers with managed health care plans.

Given news reports of mentally ill children waiting days in emergency rooms for psychiatric beds, the bill requires the state to implement new policies and procedures to ensure patients don't become "stuck." It also reorganizes the state structure for children's mental health and creates new interagency teams to work together on individual cases.

Advocates say the legislation will cost the state $5.4 million annually, pointing out that the system has been underfunded for years. If the Senate's legislation is left intact by the House and approved, it will be forwarded to Gov. Deval Patrick. The bill sits in the House Ways and Means Committee and must be sent to a vote before the end of the legislative session Thursday.

Proponents said they have plenty of State House support and are hopeful.

"We have every reason to believe the bill will come out," said Matt Noyes of the non-profit Health Care for All.

The only opponents, Noyes said, have been the Church of Scientology, which does not believe in mental health care, and insurance companies.

The industry dropped its opposition, however, after the Senate removed a provision requiring insurers to reimburse mental health professionals for time spent coordinating care with parents, teachers and family doctors. Noyes said the move was made because a required cost assessment for the new mandate was not released in time, with advocates intending to introduce separate legislation in the next session.

While families have pointed to the removed provision as a key to improving care, advocates said the bill still represents progress.

"Even without that, I think it would be a huge step forward," said Lois DeRusha, the parent support coordinator at Wayside Youth & Family Support Network in Framingham and the parent of a child with mental health challenges. "I don't think 10 years ago anyone would have given it the time of day."

With the legislation pending, McNamara said she can't help but look back and wonder whether things could have turned out differently. While Evan is better than before, his doctors tell her the potential for further improvement has probably been lost because he entered the residential treatment program so late.

"We would have more of my son than we do today," she said.

For his part, Evan often asks what he was able to do during the "lost years" from ages 3 to 10, when he lived engulfed in the relentless shadows of depression, psychotic thoughts and manic moods. He questions whether he played softball, went to the carnival or had a birthday party with friends.

The answer is usually, "No." For McNamara, there's only one way to cope with the loss.

"I can never give him those seven years back," she said. "The only way I can live at peace is by speaking out and going public."

Michael Morton can be reached at mmorton@cnc.com or 508-626-4338.

MetroWest Daily News

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